reference library

Personal appearance professionals in the United States — such as barbers, cosmetologists, and manicurists — must typically be licensed. These licensing requirements vary from state to state, and they are…
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Is government guiding the invisible hand at the top of the labor market? We study this question among physicians, the most common occupation among the top one percent of income…
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This report gives an overview of findings from the third wave of data collection for the After the JD Study of Lawyers’ Careers, which we refer to in this report…
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The COVID‐19 pandemic wreaked havoc on the world economy as shelter‐in‐place regulations forced individuals to stay at and work from home. Brick and mortar testing centers, whether run as part…
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We show that occupational licensing has significant negative effects on labor market fluidity defined as cross-occupation mobility. Using a balanced panel of workers constructed from the CPS and SIPP data,…
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People living in rural areas have worse health outcomes than their urban counterparts do. Understanding what factors account for this could inform policy interventions for reducing rural-urban disparities in health….
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Following the 2008 financial crisis (which occurred during the Great Recession that began in December 2007), businesses and corporations experienced substantial difficulty in accessing credit required to maintain operations at…
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The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health…
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Why are prices in some sectors increasing dramatically even as economy-wide technology and productivity improves? Education and healthcare are notable examples of sectors seemingly stricken by constantly rising prices. Educational…
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Occupational licensing laws have been relaxed in a large number of U.S. states to give nurse practitioners the ability to perform more tasks without the supervision of medical doctors. We…
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All PAs must practice with a collaborating physician; however, state laws dictate the extent of that relationship. This interactive guide provides an overview of PA scope of practice laws by…
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In 2005 the United States spent $6,401 per capita on health care-more than double the per capita spending in the median Organization for Economic Cooperation and Development (OECD) country. Between…
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The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting…
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” Pew Health Professions Commission endorses the need to reform the regulatory system, the general vision articulated by the Taskforce on the future of the system, and the invitation to…
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“The Federation of State Medical Boards (the Federation) is a national non-profit association whose membership includes all medical licensing and disciplinary boards in the United States, and the U.S. territories….
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This brief describes a range of state-based regulations or policies that either limit or prohibit dental hygienists from sealing children’s teeth at school, or create financial burdens that work against…
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The role of licensing in driving up healthcare costs has been almost completely ignored. The apparent explanation is that nobody can imagine that there is any alternative. The obvious complexity…
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“Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care,…
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In recent years, college graduates have found themselves increasingly saddled with student loan debt. Even worse, many of these graduates fall behind on that debt sometimes through no fault of…
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This article uses data from the Current Population Survey to analyze the role of professional certifications and occupational licenses in the U.S. labor market. It discusses the prevalence of these…
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The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence…
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A growing body of evidence shows that areas with robust primary care systems tend to have better outcomes and lower per capita costs than areas that rely more on specialists….
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Wisconsin issues four different types of credentials, which are: licenses, certificates, registrations, and permits. All types collectively are commonly referred to as credentials. For the purposes of this report, the…
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Howell, Baker, Glyn, and Schmitt (HBGS) challenge the consensus view (the “orthodox” view, as they call it) on the causes of European unemployment trends. Numerous papers in this literature examine…
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The objective of this report is to detail the health, safety and economic contributions of the professional beauty industry and the critical role professional beauty licensing plays in protecting those…
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Child care in the United States is expensive, but its cost varies greatly by region. Data from Child Care Aware of America, a nonprofit that works in child-care policy, indicate…
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The term “free trade” has been grossly misused in trade debates. Free trade has generally meant removing barriers on trade in goods, the effect of which is to put downward…
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An effective health care system needs to coordinate medical facilities with the behavioral and economic drivers in communities that are most related to good long-term health. Intermediaries can help this…
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There is a significant geographic variation in anesthesia provider supply. Lower supply in rural communities raises concerns about access to procedures that require anesthesia in rural areas. State policies related…
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Pharmacists have been prescribing in the UK since 2003, following the success of nurse prescribing. The review of prescribing, supply and administration of medicines (the second Crown Report) in 1999…
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In an era characterized by high levels of U.S. health-care spending and inadequate health outcomes, it is vital for policymakers to explore opportunities for enhancing productivity. Important productivity gains could…
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This paper examines the impact of California’s hospital closures occurring from 1995-2011 on adjusted inpatient mortality for time-sensitive conditions: sepsis, stroke, asthma/chronic obstructive pulmonary disease (COPD) and acute myocardial infarction…
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This study provides a comprehensive assessment of access to mental health and substance use disorder (SUD) treatment in Michigan. It identifies current challenges and provides a baseline against which progress…
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BPOA worked in coordination with Saint Francis University’s Knee Center for the Study of Occupational Regulation (CSOR) to compile data on regional equivalent professional and occupational licensure. The report found…
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Many opioid control policies target the prescribing behavior of health care providers. In this paper, we study the first comprehensive state-level policy requiring providers to access patients’ opioid history before…
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Beneficiaries attributed to PCNPs had lower hospital admissions, readmissions, inappropriate emergency department use, and low-value imaging for low back pain. Beneficiaries attributed to PCMDs were more likely than those attributed…
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PURPOSE Evidence that fewer children are being seen at family physician (FP) practices has not been confirmed using population-level data. This study examines the proportion of children seen at FP…
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This report provides an overview of the need to expand professional, business, and commercial licenses (also known as “occupational licenses”) to various work-authorized immigrants. The report provides an overview of…
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In this policy brief, we use a novel dataset generated using OL RegData to explore differences in the stringency of occupational licensing for select states in the Midwest and mid-Atlantic…
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Whatever one’s opinion of the federal and state government response to the COVID-19 pandemic, the virus and associated “shelter at home” orders clearly had a devastating impact on the U.S….
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COVID-19 and our response have caused economic disruption, forcing businesses to close and millions to become unemployed. Although we have seen some recovery, the number of people currently unemployed remains…
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This report concludes that DEA and SAMHSA have the legal authority to extend the flexibilities granted during the COVID-19 public health emergency without additional authorization from Congress. DEA and SAMHSA…
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Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may…
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Arkansas policy makers are aware of their state’s high criminal recidivism rates (the percentage of released prisoners that reoffend). The criminal justice reforms in Arkansas have also indicated that policy…
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Occupational licensing laws create minimum standards that individuals must meet to work in a number of fields. These minimum standards usually include competency tests, hours of practice, application fees, and…
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There is a need in the United States for greater access to dental and oral health services. As of 2018, over five thousand three hundred dental Health Professional Shortage Areas…
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Primary care physicians (PCPs) provide frontline health care to patients in the U.S.; however, it is unclear how their practice styles affect patient care. In this paper, we estimate the…
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The American Association of Nurse Practitioners® (AANP) released both the new national nurse practitioner (NP) count and findings from its 2018 National Nurse Practitioner Sample Survey. As of January, a…
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Nurse practitioners (NPs), physician assistants (PAs), and certified nurse midwives (CNMs) represent a growing part of the nation’s primary care workforce. These Advanced Practice Clinicians help expand primary care capacity…
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This article elaborates and evaluates the neo-Weberian notion of social closure to investigate positional inequality in the United States. It argues that social and legal barriers around occupations raise the…
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During the past few decades, licensure, a state-enforced mechanism for regulating occupational entry, quickly became the most prevalent form of occupational closure. Broad consensus among researchers holds that licensure creates…
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I examine the effects of mandatory occupational licensure on the quality of Certified Public Accountants (CPAs) using the staggered state-level adoption of the 150-hour Rule (the Rule). Although the Rule…
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In A Fair Chance: Simple steps to strengthen and diversify the teacher workforce, NCTQ analysis reveals both astonishingly high numbers of elementary teacher candidates failing their professional licensing tests each…
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We assess the welfare consequences of occupational licensing for workers and consumers. We estimate a model of labor market equilibrium in which licensing restricts labor supply but also affects labor…
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The aim of this study was to explore current Australian Nurse Practitioners (NPs) models of prescribing used and medicines prescribed within their scopes of practice. An online survey of Australian…
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Wide variation exists between the nursing competence requirements seen in the emergency care context and the subsequent design of nursing education programmes. Clarifying nursing roles and scope of prac- tice…
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Nearly 30 percent of American jobs require a license today, up from less than five percent in the 1950s. For some professions, occupational licensing is necessary to protect the public…
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Telecontraception is the provision of contraception prescriptions online as an alternative to traditional clinic visits. In this study, standardized patients were asked to represent a range of relative and absolute…
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This study finds that roughly 19 percent of American workers now have a license to work, with individual state percentages ranging from about 14 to 27 percent. It also finds…
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For decades, U.S. rural areas have experienced shortages of primary care providers. Nurse practitioners (NPs) are helping to reduce that shortage. However, NP scope of practice regulations vary from state-to-state…
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Our aim in conducting the State Medical Boards Awareness Study was to measure national awareness of state medical boards, as well as gain insights on Americans’ experiences with, and responses…
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The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence…
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Access to quality primary care is challenging for rural populations and individuals residing in primary care health professional shortage areas (HPSAs). The ability of nurse practitioners (NPs) to provide full…
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The U.S. healthcare system is facing workforce shortages in rural and primary care settings. Despite growing demand for providers and comparable quality metrics, advanced practice registered nurses (APRNs) still face…
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Political leadership from the governor was one of the strongest factors influencing whether or not licensing was reformed. Governors accomplished this in a myriad of ways. Both Michigan Governor Rick…
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Debates over economic policy are often framed as conservatives supporting market-oriented policies, while progressives support government interventions. However, there are many market-oriented policies that can lead to more equality, an…
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Family physicians’ scope of practice is declining despite being well prepared to provide a range of clinical services. To evaluate whether this is a new phenomenon, we compared the proportions…
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Reduced competition among clinicians leads to higher prices for health care services, reduces choice, and negatively impacts overall health care quality and the efficient allocation of resources. Government policies have…
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Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine…
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For the past few decades, the United States has not produced enough primary care physicians. Moreover, too few physicians practice in rural and medically underserved areas, and the number of…
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“This project explored the effects of nurse practitioner (NP) scope of practice (SOP) legislation on the distribution and practice patterns of NPs as well as their billing practices. The goal…
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Many states allow nurse practitioners (NPs) to practice and prescribe drugs without physician oversight, increasing the number of autonomous primary care providers. We estimate the causal impact of NP independence…
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Nurse practitioners (NPs) and physician assistants (PAs) now outnumber family practice doctors in the United States and are the principal providers of primary care to many communities. Recent growth of…
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It is widely recognized that there is significant state-level variation in scope-of-practice regulations (SSoPRs) for nurse practitioners (NPs). This study was designed to examine whether SSoPRs influence labor markets for…
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Nurse practitioners have become an increasingly important part of the US medical workforce as they have gained greater practice authority through state-level regulatory changes. This study investigates one labor market…
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Pharmacists have been shown to be beneficial for inclusion in emergency department (ED) services; however, little has been done to assess these benefits with pharmacists having even wider scopes of…
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There has been a dramatic increase in the authority granted to nurse practitioners (NP) and physician assistants (PA). This “expanded” authority has changed who can provide health‐care services and has…
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This article uses data from the Current Population Survey to analyze the role of professional certifications and occupational licenses in the U.S. labor market. It discusses the prevalence of these…
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Strengthening health care overall is essential to the health of our nation and promoting access to health care as well as controlling health care costs in a quality cost-effective manner….
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“The use of nurse practitioners (NPs) is one way to address the shortage of physician primary care providers. NP training programs and the number of practicing NPs have increased in…
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Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different…
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Occupational licensing laws have been relaxed in a large number of US states to give nurse practitioners the ability to perform more tasks without the super-vision of medical doctors. We…
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Nonphysician providers (NPPs) increasingly perform imaging-guided procedures, but their roles interpreting imaging have received little attention. We characterize diagnostic imaging services rendered by NPPs (i.e., nurse practitioners and physician assistants)…
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This paper considers how the decision to enter advanced practice nursing (e.g., the occupations of nurse practitioner, certified nurse-midwife, nurse anesthetist, and clinical nurse specialist) is affected by State laws…
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We exploit state variation in licensing laws to study the effect of licensing on occupational choice using a boundary discontinuity design. We find that licensing reduces equilibrium labor supply by…
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“Little is known about the geographic distribution of the overall primary care workforce that includes both physician and nonphysician clinicians–particularly in areas with restrictive nurse practitioner scope-of-practice laws and where…
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“Policymakers and clinicians are concerned that future growth in demand for health care services will exceed current provider supply. One potential solution to meeting this demand is expanding the number…
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The criminal justice system is becoming automated. At every stage, from policing to evidence to parole, machine learning and other computer systems guide outcomes. Widespread debates over the pros and…
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“Access to quality primary care is challenging for rural populations and individuals residing in primary care health professional shortage areas (HPSAs). The ability of nurse practitioners (NPs) to provide full…
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The provision of health care to low-income Americans remains an ongoing policy challenge. In this paper, I examine how important changes to occupational licensing laws for nurse practitioners and physician…
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Nurse practitioners (NPs) and physician assistants (PAs) now outnumber family practice doctors in the United States and are the principal providers of primary care to many communities. Recent growth of…
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This analysis draws upon data from the Organization for Economic Cooperation and Development and other cross-national analyses to compare health care spending, supply, utilization, prices, and health outcomes across 13…
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The summary goes here Douglas W Roblin, David H Howard, Edmund R Becker, E Kathleen Adams, and Melissa H Roberts Health Services Research June 2004 External Link

State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality…
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Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients’ legal burdens in establishing…
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Public choice theory has long been the dominant lens through which economists and other scholars have viewed occupational licensing. According to the public choice account, practitioners favor licensing because they…
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The District of Columbia has many factors in its favor making it attractive to workers: high average wages, a variety of employer benefits, strong worker protections, and relatively short commute…
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The increased use of nurse practitioners (NPs) and physician assistants (PAs) represents an important option for increasing access to healthcare. I explore the effect of two types of laws on…
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The demand for health care and healthcare professionals is predicted to grow significantly over the next decade. Securing an adequate health care workforce is of primary importance to ensure the…
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Higher health care prices in the United States are a key reason that the nation’s health spending is so much higher than that of other countries. Our study compared physicians’…
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